title: Spontaneous coronary artery dissection in a young man - case report.
abstract: A 31 year old man with a 17-year-history of drug abuse (heroine and cannabis) was admitted with recurrent chest pain over a period of about three weeks. Chest discomfort severely worsened during the 5 hours before hospital admission. Electrocardiography revealed poor R-wave progression and non specific repolarization abnormalities. Echocardiography showed extensive left ventricular anterior and apical wall motion abnormalities and a ventricular thrombus located at the apex of the left ventricle was present. Subsequently, a diagnosis of acute coronary syndrome was made. Coronary angiography revealed spontaneous coronary artery dissection of the left anterior descending (LAD) artery with Thrombolysis In Myocardial Infarction (TIMI) flow 2 to 3. We managed the patient conservatively. The clinical course was uneventful and repeated angiography on day 4 demonstrated spontaneous healing of large parts of the dissection with TIMI 3 flow in the LAD.
authors.affiliation: Department of Cardiology and Intensive Care, General Hospital Braunau, Austria, Ringstrasse 60, A - 5280 Braunau am Inn, Austria. johann.auer@khbr.at
authors.forename: Julia
authors.initials: J
authors.lastname: Schmid
authors.forename: Johann
authors.initials: J
authors.lastname: Auer
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D003937:Diagnosis, Differential; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous; D019966:Substance-Related Disorders / Q000150:complications*; D015912:Thrombolytic Therapy / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents